Herniated Disc: Causes, Symptoms, and Treatment

Got chronic back pain? You may suspect a herniated disc as the culprit. Maybe a doctor told you that you have one after doing an MRI, or you strongly think it based on your back pain symptoms and a visit with Dr. Google. 

So whether you’ve been diagnosed with a herniated disc or not, don’t feel like you’re stuck or doomed to a lifetime of pain. You don't have to be. Conservative at-home treatments, including targeted exercises can help you manage the pain and prevent or minimize future flare-ups. 

Here, learn more about what a herniated disc is, how to prevent and treat it, and which exercises can help relieve your back pain, recommended by our Hinge Health physical therapists.

What Is a Herniated Disc? 

A herniated disc occurs when the center of one (or more) of the flat, round discs — that are located between vertebrae in the spine and act as shock absorbers, enabling the spine to be flexible — pushes against its outer ring. This can sometimes cause back pain or neck pain.

If you’ve heard someone refer to a herniated disc as a bulging disc, the terms are often used interchangeably, but they’re actually medically different. With a bulging disc, the jelly-like inner core doesn’t get squeezed out of its outer ring. It may protrude a bit, but it doesn’t exit the outer ring, which is what occurs when a disc herniates. Regardless of terminology, the symptoms and treatment are often the same.  

And here’s another misconception: That all herniated discs cause pain. That’s not always the case. “While a herniated disc can contribute to chronic low back pain and make it worse, it’s likely not the main cause,” says Steve Goostree, PT, DPT, a physical therapist at Hinge Health. In fact, research shows that 30% of 20-year-olds and 84% of 80-year-olds with no back pain show signs of a herniated disc on an MRI. 

In other words, because herniated discs are easy to see on imaging of your back, it’s easy to assume they are causing your back pain. But it can be the case that you can have herniated discs that aren’t causing any symptoms — along with other reasons your back is bothering you. ç

What Causes a Herniated Disc?

Here are common reasons you may experience a herniated disc:

• Age-related changes in the spine. The most common cause of a herniated disc is natural, age-related changes in your spine. Over time, the discs in your spine start to shrink and become less flexible. This causes the spaces between your vertebrae to narrow.

• An injury. As you get older, even a minor strain or twisting movement — for example, from lifting a heavy object — can cause a disc to herniate.

• Genetics. Research shows that some families have a higher risk of developing herniated discs along their spine. It’s not clear why this happens.

• Age and sex. Men between the ages of 20 and 50 are more likely to have disc herniation than other groups.

Symptoms of a Herniated Disc

Remember, herniated discs don’t always cause back pain. But if they do, you might experience the following: 

• Sharp or burning pain on one side of your body 

• Leg pain that spreads from your low back to your buttocks, thigh, calf, and possibly foot 

• Numbness or tingling

• Muscle weakness that may cause you to stumble 

If you’re prone to pain from a herniated disc, the pain may flare and subside on occasion. “It’s important to remember that a herniated disc in the lower back is no reason to panic,” says Dr. Goostree. “They do have a tendency to heal, so that you’re not burdened with them your whole life.” The herniation should naturally resolve over time and be reabsorbed by your body. In the meantime, you can use the treatments below to reduce pain while your back heals and reduce the chances of future pain flares.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Herniated Disc Treatment

Most of the time, a herniated disc gets better on its own after several days or weeks. But you can help speed the process along with the following tips from our Hinge Health physical therapists and medical doctors:

• Physical therapy. Physical therapy can aid in easing low back pain that may be related to a herniated disc, especially if you prefer to exercise with some support. A physical therapist (PT) can create a personalized treatment plan that includes targeted herniated disc exercises (like the ones above) to strengthen the muscles supporting the spine, improve flexibility and posture, and reduce the pressure on the herniated disc. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Prescription drugs. Commonly prescribed prescription drugs for herniated discs are neuropathic drugs, which affect nerve impulses to decrease pain. These include gabapentin (Neurontin), pregabalin (Lyrica) and duloxetine (Cymbalta). Some doctors prescribe muscle relaxers if you also have muscle spasms, but they do carry side effects such as drowsiness and dizziness.

• Steroid injections. If over-the-counter medication and conservative treatments don’t offer sufficient pain relief, your doctor may suggest cortisone steroid injections. They can offer back and leg pain relief by decreasing inflammation near the nerve roots. “It’s important to remember that injections won’t heal a herniated disc,” explains Dr. Goostree. “They will just help reduce inflammation that may temporarily be contributing to pain.”

• Surgery. About 90% of people with a herniated disc get better with the above treatments and surgery is usually not necessary. You may be a candidate for surgery, though, if your pain does not improve with non-invasive treatments and you experience muscle weakness, difficulty walking, and loss of bladder or bowel control. Talk to your doctor about whether you’re a good candidate for surgery. 

How to Prevent a Herniated Disc

There are a lot of things you can do to reduce your chances of developing a herniated disc. They include:

• Maintain a healthy weight for you. Excess body weight can put added stress on the discs in your lower back.

• Prepare your body to lift. If you need to lift heavy objects, practicing is important. Exercise and movement can make your discs thicker and stronger. But avoid lifting drastically more weight than you are used to or, when you are tired. Ask for help or find some equipment to help you.

• Stay active. A sedentary lifestyle makes it more likely that you’ll end up with a herniated disc. When you have to sit for long periods of time, take frequent breaks to move or stretch. “I also recommend patients use a pillow or support behind their back when they sit,” says Dr. Goostree. This can support the natural curvature of your spine and reduce strain on your back. 

• Don’t smoke. Nicotine decreases blood and oxygen flow to your spinal discs, which can cause them to age more rapidly. 

• Stay hydrated. Discs are made up mostly of water, so dehydration might make you more prone to herniation. 

PT Tip: Stay Active

It’s fine to take it easy for a day or two if your back hurts, says Dr. Goostree. But after that, you want to get moving again. In fact, pain researchers say it’s best to stay at work or go back to work as soon as possible. This encourages blood and oxygen delivery to tissues for healing, keeps muscles strong and limber, and helps reduce pain. Once you become active again, avoid sitting for long periods. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Lumbar Disc Herniation with Radiculopathy. (2012). North American Spine Society. Retrieved from https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf

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4. Herniated Disc—Symptoms, Causes, Prevention and Treatment. (n.d.). American Association of Neurological Surgeons. Retrieved from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc 

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6. Surkitt, L. D., Ford, J. J., Hahne, A. J., Pizzari, T., & McMeeken, J. M. (2012). Efficacy of Directional Preference Management for Low Back Pain: A Systematic Review. Physical Therapy and Rehabilitation Journal, 92(5), 652-65. doi:10.2522/ptj.20100251

7. Ma, C. B. & Zieve, D. (July 28, 2021). Lifting and Bending the Right Way. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000414.htm 

8. O'Keeffe, M & O'Sullivan, K. (2019, April 9). All you ever wanted to know about back pain. Raidió Teilifís Éireann, Ireland’s National Public Servivce Media. https://www.rte.ie/brainstorm/2018/0130/937071-all-you-ever-wanted-to-know-about-back-pain/